-Reforms to postgraduate training in the UK may affect recruitment to geriatric medicine. In 2005, a questionnaire survey was undertaken to determine the factors favouring geriatric medicine as a career choice and whether these might be used to influence recruitment.In all, 1,036 responses to the questionnaire were received (response rate 56.4%); 4% of the respondents decided to specialise in geriatric medicine as students, 3.8% of consultants and 8.6% of registrars decided as pre-registration house officers while 39% of consultants and 7% of registrars chose geriatric medicine while a middle grade in another specialty. The strongest influences on choice were clinical aspects of the specialty (34.1%) and inspirational seniors (26.2%). However, 9.2% of consultants and 10.1% of registrars subsequently regretted their career decision.Geriatric medicine seems to be a career choice for doctors of increasing maturity and including more posts in foundation programmes may not improve recruitment as anticipated. Although a small number of doctors regretted choosing geriatric medicine as a career, this was rarely to do with core aspects of the specialty. KEY WORDS: career choice, geriatric medicine, recruitment IntroductionPostgraduate training has changed dramatically with the introduction of Modernising Medical Careers (MMC) and the start of foundation programmes in August 2005. 1 One of the aims of foundation training is to enable trainees to experience a wider range of specialties during the early part of their career enabling them to make better informed career choices. It is hoped that foundation training may influence final career choices as doctors are expected to enter basic training upon completion of the programmes.Studies of the career choices of medical school graduates 2 have shown that about a quarter of doctors change their career choice between one and three years after qualification, and less than half consider their decision in year 3 as final. Respondents are not usually specific about a choice of specialty within hospital medicine; the small numbers of those that are, however, rarely express a preference to train in geriatric medicine. 3 Conflicting evidence exists as to whether early career choice is an accurate predictor of final career decisions. Eighty per cent of doctors who selected psychiatry three years after qualifying, for example, were still working in it 10 years later. 4 The 10th annual report of 1995 graduates performed by the BMA suggest different patterns. 5 Immediately after qualifying, 18% of graduates intended to pursue a career in general practice but 10 years later this figure rose to 35%. Conversely, in the same time frame, 20% intended to enter general medicine but this fell to just 6%.A survey of doctors currently training and working in geriatric medicine in the UK was recently undertaken to determine when they made their career decision, what the influencing factors were and whether they had any regrets. MethodsThe questionnaire was piloted on consultants and special...

Some health authorities in the UK are discontinuing hearing screening at school entry, mainly because the pure tone sweep test is under-specific (i.e. fails too many children) and thus leads to unnecessary and costly, but unproductive, follow-up assessment. A screening method with different properties such as a questionnaire could be a more cost-effective method of mass screening children. The MRC Institute of Hearing Research has developed and evaluated through several stages such a screening questionnaire (the Childhood Middle Ear Disease and Hearing Questionnaire (CMEDHQ), containing 11 scored questions under two broad headings: history and presentation of the disease, and consultation/treatment history. In a service-based evaluation, 2860 mainstream reception-year school children from two consecutive years, attending schools in south west Cumbria in the North-West Regional Health Authority received the sweep test and the CMEDHQ. (Although predominantly designed to detect middle ear problems, the questionnaire also has some potential to detect permanent hearing loss; thus providing a useful backstop for detection of permanent losses either missed or not present in earlier infancy.) The screening CMEDHQ obtained a very high response rate (90%). Follow-up included 235 control cases as well as all pure tone sweep test failures. Analysis, by use of a definition of cases conservative with respect to the sensitivity of the questionnaire, showed that the CMEDHQ has better specificity, but slightly lower sensitivity, than the pure tone sweep test for composite system decision (where 'case' = treated at ENT; 'non-case' = pass at whatever stage was reached before discharge). Follow-up indicated that the limited method available for assessing sensitivity might give an over-favourable view of the pure tone sweep test. Possible improvement of questionnaire sensitivity by further refinements is under examination. The findings show that it is worth conducting a fully parallel multi-district cost-effectiveness comparison of the pure tone sweep test versus the CMEDHQ.